3种胸膜增厚性疾病的CT诊断价值  

The value of CT diagnosis in three kinds of pleural thickening lesions

作　　者：李文斌 纪晓微 蔡蒙婷 陈聪[1] 吴恩福[1] LI Wenbin;JI Xiaowei;CAI Mengting;CHEN Cong;WU Enfu(Department of Radiology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou,325015)

机构地区：[1]温州医科大学附属第一医院放射科,浙江温州325015

出　　处：《温州医科大学学报》2018年第6期446-449,共4页Journal of Wenzhou Medical University

摘　　要：目的:探讨CT对结核性胸膜炎(TP)、胸膜转移瘤(MPD)、恶性胸膜间皮瘤(MPM)的诊断及鉴别诊断价值。方法:回顾性分析2008年1月至2017年4月温州医科大学附属第一医院经临床及病理证实的143例患者(TP组95例,MPD组31例,MPM组17例)的CT影像学资料,分析各个疾病的影像学特征,探讨其鉴别诊断意义。结果:TP组多为男性,多表现为局限性、规则、非环形胸膜增厚,均匀强化,不伴纵隔胸膜增厚及胸内淋巴结肿大;MPD组多为女性,多表现为弥漫性、不规则和结节样、非环形胸膜增厚,均匀强化,伴纵隔胸膜增厚,不伴胸内淋巴结肿大;MPM组多为女性,多表现为弥漫性、结节样和肿块样、非环形胸膜增厚,不均匀强化,不伴纵隔胸膜增厚及胸内淋巴结肿大。TP组年龄小于MPD组及MPM组(P<0.05);TP组胸膜最大厚度小于MPD组,MPD组胸膜最大厚度小于MPM组(均P<0.05)。结论:患者年龄,性别,最大胸膜厚度,病变范围、形态、样式,强化模式,纵隔胸膜增厚,胸内淋巴结肿大对于TP、MPD、MPM的鉴别诊断具有一定价值。Objective： To explore the value of CT in the diagnosis and differential diagnosis of tuberculous pleurisy（TP）, metastatic pleural disease（MPD） and malignant pleural mesothelioma（MPM）. Methods： The CT images of 143 patients with pleural thickening（TP 95, MPD 31, MPM 17） proved pathologically were reviewed retrospectively in the First Affiliated Hospital of Wenzhou Medical University from January 2008 to April 2017. Combined with CT imaging data, imaging features of each disease were analyzed, and the significance of differential diagnosis was discussed. Results： In patients with TP, the most common features were male, local, smooth and non-circumferential pleural thickening, homogenous enhancement, no mediastinal pleural involvement with lymph node enlargement. Female, diffuse, irregular, nodular, non-circumferential pleural thickening, homogenous enhancement and mediastinal pleural involvement without lymph node enlargement were more frequently seen in MPD group. Female, diffuse, nodular non-circumferential pleural thickening, pleural based mass, inhomogeneous enhancement, no mediastinal pleural involvement and lymph node enlargement were more frequently seen in MPM group. TP group was younger than MPD group and MPM group. The maximal pleura thickness of TP group was shorter than that of MPD group, which was even shorter than that of MPM group. Conclusion： Age, sex, maximum pleural thickness, lesion range, shape, style, enhancement pattern, mediastinal pleural involvement and lymph node enlargement were factors of significance in differentiating tuberculous pleurisy, pleural metastases and malignant pleural mesothelioma.

关 键 词：电子计算机断层扫描 结核性胸膜炎 胸膜转移瘤 恶性胸膜间皮瘤 

分 类 号：R816.41[医药卫生—放射医学]